This CTSA application from Washington University in St. Louis (WU) is built on a long institutional history of outstanding biomedical research, research training, and patient care. WU is the recipient of the 4 clinical research and training grants that form the basis of the CTSA (GCRC, currently in its 46th year of funding, and K12, K30, and T32 grants.) Another critical element is WU's new BioMed 21 strategic initiative in multidisciplinary, collaborative research in genome sciences, biological imaging, and clinical investigation. All these elements will be conjoined with other existing resources at WU to form a transformational new Institute of Clinical and Translational Sciences (ICTS). By implementing the 15 key Program Functions described in this application, the ICTS will conceptually and operationally reinvent and reinvigorate clinical and translational research and clinical research training at WU. An unprecedented level of partnership with other academic, healthcare, community and scientific institutions that complement our core expertise in laboratory and clinical research and research training is central to the transformation that will be led by the ICTS. Our partners include BJC HealthCare, an integrated academic and community health care delivery system; Saint Louis University School of Public Health, Graduate School and Doisy College of Health Sciences; University of Missouri St. Louis College of Nursing; Southern Illinois University Edwardsville School of Nursing; and St. Louis College of Pharmacy; key organizations promoting community health as well as biomedical and pharmaceutical companies in the St. Louis area. The coupling of these resources creates an outstanding environment to make basic laboratory discoveries that can then be translated into clinical research protocols and ultimately into advances in clinical practice and patient care through extensive community interactions and commercial partnerships. __T.o ensure the success of the ICTS, WU has made substantial commitments of space and financial support. Barnes-Jewish and St. Louis Children's Hospitals, our academic hospital partners, and BJC HeatthCare7Our afflliale^Tiealtlrrsystern, have also made substantial commitments to the clinical research activities of the ICTS. These additional resources coupled with the existing high quality programs in clinical and translational science ensure that WU will make outstanding contributions to this NIH initiative.